A client admitted to the psychiatric unit diagnosed with major depression wants to sleep during the day, refuses to take a bath, and refuses to eat. Which nursing intervention should the nurse implement first?

Choice A reason: Leg numbness is not a typical symptom of thyroid dysfunction and may be related to other conditions such as peripheral neuropathy.

Choice B reason: Cold sensitivity is a common symptom of hypothyroidism and warrants evaluation of thyroid function.

Choice C reason: Slow weight loss is not a typical symptom of thyroid dysfunction; unexplained weight gain is more indicative of hypothyroidism.

Choice D reason: Muscle weakness can be associated with various conditions, but cold sensitivity is more specific to thyroid issues.

Choice A reason: Listing the procedural steps is helpful but does not demonstrate practical competence.

Choice B reason: Reviewing glycosylated hemoglobin levels provides information about long-term glucose control but does not directly assess the technique.

Choice C reason: Adolescents (ages 12–18) are in a developmental stage where peer validation is a powerful motivator. By demonstratingto a peer, the adolescent is forced to internalize the steps well enough to explain them. This confirms a higher level of mastery than simply repeating steps back to a dynamic authority figure like a nurse.In a testing environment, "demonstrating the technique" to a peer does not mean the nurse allows the adolescent to actually stick a needle into another person. It means the adolescent acts out the procedure (perhaps using a practice pad, an orange, or a needleless syringe) while explaining the steps to the peer. The nurse is the observer in this scenario. The adolescent is the "teacher," and the peer is the "audience."

Choice D reason: Describing the level of comfort provides insight into his confidence but not necessarily his technical competence.